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Hamstring Otogrefti ile Tek Demet Ön Çapraz Bağ Rekonstrüksiyonlarında Klinik Sonuçlarımız

Yıl 2019, Cilt: 5 Sayı: 3, 504 - 509, 01.01.2019

Öz

Amaç: Hamstring otogrefti kullanılarak yapılan tek demet ön çapraz bağ ÖÇB rekonstrüksiyonlarının sonuçlarının değerlendirilmesi ve fonksiyonel sonuçlara etki eden faktörlerin incelenmesi. Gereç ve Yöntemler: ÖÇB rüptürü nedeniyle 2006-2011 yılları arasında opere edilen 60 hasta retrospektif olarak değerlendirildi. Tüm hastaların ameliyat öncesi ve sonrası şikâyet ve fizik muayene bulguları kayıt altına alındı. Fonksiyonel sonuçların değerlendirilmesi için Tegner-Lysholm skorlama sistemi ve Uluslararası Diz Dokümantasyon Komitesi UDDK değerlendirme formu kullanıldı. İstatistiksel değerlendirme için Mann-Whitney U testi, Ki-kare testi ve Spearman korelasyon analizi SPSS 15.0 da kullanıldı. Bulgular: Çalışmaya dahil edilen 60 hastanın tamamı erkekti. Hastaların ortalama takip zamanı 16 ay 12-20 ay ve yaş ortalamasının 27,3 17-42 yıl olduğu görüldü. Tegner-Lysholm skorlama sistemine göre 45 hastada mükemmel sonuç ve UDDK değerlendirme formuna göre 29 hastada normal diz elde edildiği görüldü. Hastaların ameliyat öncesi ve sonrası ortalama Tegner-Lysholm ve UDDK skorları karşılaştırıldığında arada anlamlı fark olduğu görüldü p=0,026 ve p=0,035 . ÖÇB rekonstrüksiyonu yapılan 28 %46,6 hastada eşlik eden menisküs yırtığı mevcuttu. Hem lateral hem de medial menisküs yırtığı bir arada olan hastalarda Tegner-Lysholm ve UDDK sonuçlarının daha düşük olduğu görüldü ancak anlamlı bir ilişki saptanamadı p=0,217 . Sonuç: Tek demet ÖÇB rekonstrüksiyonu ile hastaların ameliyat sonrası aktivite skorları anlamlı artış göstermektedir. Eşlik eden meniskal patolojilerin rekonstrüksiyon sonrası fonksiyonel sonuçta payları minimaldir

Kaynakça

  • Yasen SK, Borton ZM, Eyre-Brook AI, Palmer HC, Cotterill ST, Risebury MJ, Wilson AJ. Clinical outcomes of anatomic, all-inside, anterior cruciate ligament (ACL) reconstruction. Knee 2017; 24(1):55-62.
  • Beyzadeoğlu T, Kocadal O. Ön çapraz bağ yaralanmaları. İçinde: Doral MN, Aşık M, Akseki D, Müezzinoğlu S, Özsoy H, ed. Artroskopik cerrahi güncel bilgiler ve teknik. 1. basım. İstanbul: İstanbul Medikal Yayıncılık, 2016:87- 104.
  • Csintalan RP, Inacio MC, Funahashi TT. Incidence rate of anterior cruciate ligament reconstructions. Perm J 2008; 12:17-21.
  • Nordenvall R, Bahmanyar S, Adami J, Stenros C, Wredmark T, Fellander-Tsai L. A population-based nationwide study of cruciate ligament injury in Sweden, 2001-2009: Incidence, treatment, and sex differences. Am J Sports Med 2012; 40:1808-13.
  • Diz eklemi bağ ve tendon sorunları. Taşer ÖF, Mahiroğulları M, Karahan M, Taşkıran E, Bal E ed. 1. basım. İstanbul: İstanbul Medikal Yayıncılık, 2016.
  • Gillquist J, Messner K. Anterior cruciate ligament reconstruction and the long-term incidence of gonarthrosis. Sports Med 1999; 27:143–56.
  • Nordenvall R, Bahmanyar S, Adami J, Mattila VM, Fellander-Tsai L. Cruciate ligament reconstruction and risk of knee osteoarthritis: the association between cruciate ligament injury and post-traumatic osteoarthritis. A population based nationwide study in Sweden, 1987– 2009. PLoS One 2014; 9: e104681.
  • Jackson DW, Evans NA. Arthroscopic treatment of anterior cruciate ligament injuries. In: McGinty JB, ed. Operative arthroscopy, 1st ed. Philadelphia: Lippincott Williams & Wilkins, 2004.
  • Mikami, S, Yasuda K, Katsugori R. Reduction of inıtial tension in the in situ frozen anterior cruciate ligament. Clin Orthop Relat Res 2004; (419):207-13.
  • Değirmenci E, Yücel İ, Özturan K. Hamstring tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu. Bakırköy Tıp Dergisi 2010; 6:29-34.
  • Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 1985; 198:43-9.
  • Hoher J, Munster A, Klein J, Eypasch E, Tiling T. Validation and application of a subjective knee questionnaire. Knee Surg Sports Traumatol Arthrosc 1995; 3:26-33.
  • Mitsou A, Vallianatos P, Piskopakis N, Maheras S. Anterior cruciate ligament reconstruction by over-the- top repair combined with popliteus tendon plasty. J Bone Joint Surg Br 1990; 72(3):398-404.
  • Mologne TS, Friedman MJ. Anterior cruciate ligament reconstruction with bone-patella tendon-bone autograft: indications, technique, complications, and management. In: Insall JN, Scott WN, eds. Surgery of the knee. 3rd ed, Philadelphia: Churchill Livingstone, 2001.
  • Van der Hart CP, Van den Bekerom MP, Patt TW. The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament. J Orthop Surg 2008; 3:24.
  • Charlton WP, Randolph DA Jr, Lemos S, Shields CL Jr. Clinical outcome of anterior cruciate ligament reconstruction with quadrupled hamstring tendon graft and bioabsorbable interference screw fixation. Am J Sports Med 2003; 31(4):518-21.
  • Williams RJ 3rd, Hyman J, Petrigliano F, Rozental T, Wickiewicz TL. Anterior cruciate ligament reconstruction with a four-strand hamstring tendon autograft. J Bone Joint Surg Am 2004; 86-A (2):225-32.
  • Gifstad T, Sole A, Strand T, Uppheim G, Grontvedt T, Drogset JO. Long-term follow-up of patellar tendon grafts or hamstring tendon grafts in endoscopic ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 2013; 21(3):576-83.
  • Shahpari O, FallahKezabi M, Kalati HH, Bagheri F, Ebrahimzadeh MH. Clinical outcome of anatomical transportal arthroscopic anterior cruciate ligament reconstruction with hamstring tendon autograft. Arch Bone Jt Surg 2018; 6(2):130-9.
  • Gill SS, Diduch DR. Outcomes after meniscal repair using the meniscal arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy 2002: 569-77.
  • Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury- reduction regimen. Arthroscopy 2007; 23(12):1320-25.
  • Tosi LL, Boyan BD, Boskey AL. Does sex matter in musculoskeletal Health? The influence of se and gender on musculoskeletal health. J Bone Joint Surg Am 2005; 87:1631-47.
  • Charlton W, Coslett-Charlton LM, Ciccotti MG. Correlation of estradiol in pregnancy and anterior cruciate ligament laxity. Clin Orthop Relat Res 2001; (387):165- 70.

Clinical Results of Single Bundle Anterior Cruciate Ligament Reconstruction with Hamstring Autograft

Yıl 2019, Cilt: 5 Sayı: 3, 504 - 509, 01.01.2019

Öz

Objective: To evaluate the results of single-bundle anterior cruciate ligament ACL reconstructions performed with hamstring autograft and to investigate the factors affecting the functional results.Material and Methods: SSixty patients, who were operated for ACL ruptures between years 20062011, were evaluated retrospectively. Complaints and physical examination findings of all patients before and after surgery were recorded. The Tegner-Lysholm scoring system and International Knee Documentation Committee IKDC evaluation form were used to evaluate the functional results. The Mann-Whitney U test, Chi-square test and Spearman correlation analysis via SPSS 15.0 were used for statistical evaluation.Results: All 60 patients were male. The mean follow-up time of the patients was 16 months 1220 months and the mean age was 27.3 years. Excellent results were obtained in 45 patients according to the Tegner-Lysholm scoring system and a normal knee was found in 29 patients according to the IKDC evaluation form. Preoperative and postoperative mean values of the Tegner-Lysholm and IKDC scores were significantly different p=0.026 and p=0.035 . There were concomitant meniscus tears in 28 patients 46,6% . Although the results were worse in patients with both lateral and medial meniscus tears, there was no statistical difference between concurrent meniscus tears and the Tegner-Lysholm and IKDC results p=0.217 .Conclusion: The postoperative activity scores of the patients increased significantly with single-bundle ACL reconstructions. Concomitant meniscal pathologies have minimal effect on functional outcomes after reconstruction

Kaynakça

  • Yasen SK, Borton ZM, Eyre-Brook AI, Palmer HC, Cotterill ST, Risebury MJ, Wilson AJ. Clinical outcomes of anatomic, all-inside, anterior cruciate ligament (ACL) reconstruction. Knee 2017; 24(1):55-62.
  • Beyzadeoğlu T, Kocadal O. Ön çapraz bağ yaralanmaları. İçinde: Doral MN, Aşık M, Akseki D, Müezzinoğlu S, Özsoy H, ed. Artroskopik cerrahi güncel bilgiler ve teknik. 1. basım. İstanbul: İstanbul Medikal Yayıncılık, 2016:87- 104.
  • Csintalan RP, Inacio MC, Funahashi TT. Incidence rate of anterior cruciate ligament reconstructions. Perm J 2008; 12:17-21.
  • Nordenvall R, Bahmanyar S, Adami J, Stenros C, Wredmark T, Fellander-Tsai L. A population-based nationwide study of cruciate ligament injury in Sweden, 2001-2009: Incidence, treatment, and sex differences. Am J Sports Med 2012; 40:1808-13.
  • Diz eklemi bağ ve tendon sorunları. Taşer ÖF, Mahiroğulları M, Karahan M, Taşkıran E, Bal E ed. 1. basım. İstanbul: İstanbul Medikal Yayıncılık, 2016.
  • Gillquist J, Messner K. Anterior cruciate ligament reconstruction and the long-term incidence of gonarthrosis. Sports Med 1999; 27:143–56.
  • Nordenvall R, Bahmanyar S, Adami J, Mattila VM, Fellander-Tsai L. Cruciate ligament reconstruction and risk of knee osteoarthritis: the association between cruciate ligament injury and post-traumatic osteoarthritis. A population based nationwide study in Sweden, 1987– 2009. PLoS One 2014; 9: e104681.
  • Jackson DW, Evans NA. Arthroscopic treatment of anterior cruciate ligament injuries. In: McGinty JB, ed. Operative arthroscopy, 1st ed. Philadelphia: Lippincott Williams & Wilkins, 2004.
  • Mikami, S, Yasuda K, Katsugori R. Reduction of inıtial tension in the in situ frozen anterior cruciate ligament. Clin Orthop Relat Res 2004; (419):207-13.
  • Değirmenci E, Yücel İ, Özturan K. Hamstring tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu. Bakırköy Tıp Dergisi 2010; 6:29-34.
  • Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 1985; 198:43-9.
  • Hoher J, Munster A, Klein J, Eypasch E, Tiling T. Validation and application of a subjective knee questionnaire. Knee Surg Sports Traumatol Arthrosc 1995; 3:26-33.
  • Mitsou A, Vallianatos P, Piskopakis N, Maheras S. Anterior cruciate ligament reconstruction by over-the- top repair combined with popliteus tendon plasty. J Bone Joint Surg Br 1990; 72(3):398-404.
  • Mologne TS, Friedman MJ. Anterior cruciate ligament reconstruction with bone-patella tendon-bone autograft: indications, technique, complications, and management. In: Insall JN, Scott WN, eds. Surgery of the knee. 3rd ed, Philadelphia: Churchill Livingstone, 2001.
  • Van der Hart CP, Van den Bekerom MP, Patt TW. The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament. J Orthop Surg 2008; 3:24.
  • Charlton WP, Randolph DA Jr, Lemos S, Shields CL Jr. Clinical outcome of anterior cruciate ligament reconstruction with quadrupled hamstring tendon graft and bioabsorbable interference screw fixation. Am J Sports Med 2003; 31(4):518-21.
  • Williams RJ 3rd, Hyman J, Petrigliano F, Rozental T, Wickiewicz TL. Anterior cruciate ligament reconstruction with a four-strand hamstring tendon autograft. J Bone Joint Surg Am 2004; 86-A (2):225-32.
  • Gifstad T, Sole A, Strand T, Uppheim G, Grontvedt T, Drogset JO. Long-term follow-up of patellar tendon grafts or hamstring tendon grafts in endoscopic ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 2013; 21(3):576-83.
  • Shahpari O, FallahKezabi M, Kalati HH, Bagheri F, Ebrahimzadeh MH. Clinical outcome of anatomical transportal arthroscopic anterior cruciate ligament reconstruction with hamstring tendon autograft. Arch Bone Jt Surg 2018; 6(2):130-9.
  • Gill SS, Diduch DR. Outcomes after meniscal repair using the meniscal arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy 2002: 569-77.
  • Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury- reduction regimen. Arthroscopy 2007; 23(12):1320-25.
  • Tosi LL, Boyan BD, Boskey AL. Does sex matter in musculoskeletal Health? The influence of se and gender on musculoskeletal health. J Bone Joint Surg Am 2005; 87:1631-47.
  • Charlton W, Coslett-Charlton LM, Ciccotti MG. Correlation of estradiol in pregnancy and anterior cruciate ligament laxity. Clin Orthop Relat Res 2001; (387):165- 70.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Özgür Doğan Bu kişi benim

Emrah Çalışkan Bu kişi benim

Batuhan Gencer Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 5 Sayı: 3

Kaynak Göster

Vancouver Doğan Ö, Çalışkan E, Gencer B. Hamstring Otogrefti ile Tek Demet Ön Çapraz Bağ Rekonstrüksiyonlarında Klinik Sonuçlarımız. Akd Tıp D. 2019;5(3):504-9.